This includes, for example, granting unpaid holidays, token awards or recreational facilities, as well as recognition and supervision [ 19].
Important facets of job satisfaction having been identified in previous research include salary and benefits, career development, in-service training, work relationships, management, work environment, recognition and supervision [ 19, 30- 32].
HWs revealed that improvement of technical skills and use of new technologies had a positive effect by increasing feelings of professionalism coupled with patients' positive feedback; however, HWs also felt unsupported in other aspects including increased workload, and lack of recognition, payment and supervision leading to demotivation.
The comments made by nurses also pointed to other aspects of the practice environment such as poor clinic infrastructure, lack of functioning equipment, safety concerns, lack of recognition, and suboptimal supervision and management.
To train pattern recognition skills longitudinally and to provide an alignment of medical undergraduate training with PRQs in high stakes exams, students should have sufficient opportunities to practice the skill of pattern recognition and to receive supervision and feedback for their learning process [ 13, 22].
There are indications that supportive supervision, recognition and personal feedback tend to be more common in religious and private health centres in Kenya than in public facilities.
This could play an important role with respect to recognition and achievement, especially when supervision is not frequent and feed back from colleagues and managers is lacking.
Studies from sub-Saharan Africa discussing health workers' experience of working conditions point to the importance of factors such as remuneration, training, supervision, recognition and transparency in human resource management [ 6- 17].
The low attrition and the effective participation of ordinary community members as unpaid volunteers led us believe that this model can be sustained, if the required resources for their supervision, recognition and motivation can be provided.
This would also strengthen the central tenants of supervision, training, recognition, and possibly career paths for these cadres of workers.
The Delphi survey of experts ranked research collaborations, national recognition, supervision and contributions to the research environment as important indicators in low-resource countries, whereas the number of publications, which was an important output in high-resource countries, was ranked lower.
